Fertility Preservation and Chemotherapy Treatment in A Case of Pelvic Rhabdomyosarcoma: A Case Study

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2020

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Bowman, William
Dorton, Cody

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Background: Infertility is a common problem for patients undergoing cancer treatment. Agents such as cyclophosphamide and others are known to be gonadotoxic as is radiation. The loss of fertility is psychologically traumatic to patients who hope to resume a normal life following their treatment. In addition, female patients may undergo premature menopause after chemotherapy. Case Information: A 21-year-old female presented with a pelvic mass and was diagnosed to have rhabdomyosarcoma, stage 3. She was scheduled to receive chemotherapy with vincristine, actinomycin-D, and cyclophosphamide, and radiation therapy. Before commencing treatment she inquired about fertility preservation and was allowed 2 weeks for egg retrieval before start of chemotherapy. Oocyte preservation was successful, and she then began 42 weeks of chemotherapy as originally planned. She achieved remission of her cancer and remains free of disease since completion of treatment over three years ago. She experienced primary ovarian failure as a consequence of cancer treatment but may have future prospect of parenthood due to the opportunity of selective egg retrieval and freezing before chemotherapy. Conclusions: Physicians should discuss with their patients the risks of infertility resulting from cancer therapy and offer fertility preservation options when feasible. While not applicable to all with aggressive cancers there may be circumstances such as described when a window of time may be allowed for an attempt at fertility preservation

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